My Story and New TRT Journey with Questions

8thangel

New member
Hi guys,

I began TRT about 8 weeks ago and have some questions I'd like to ask. My primary concerns/questions are regarding my most recent labs 6 weeks out from beginning my TRT dose.

A little background for you on myself, I'm 42 years old 5'9" and currently 180 pounds since getting back into the gym and eating well again (I was 165 pounds back in April). I also own my own business and work... way too much. I've had horrible sleep apnea for years prior to any TRT and have been using CPAP for several years now. Additionally I've had bouts of shingles for over twelve years now and within the last 2-3 years had my first experience with post herpetic neuralgia. It lasted from about may of 2008 till February of this year. During that time I experienced some of the worst pain in my life and as a result was on some pretty serious narcotics as a result. Started out with just percocet and wound up being on a combo of percocet and MS-Contin then finally percocet and Oxycotin. Of course anyone who knows anything about these drugs knows they're very addictive and prone to abuse. My pain being at such a high level and former substance abuse issues led to a new and much worse problem with the meds listed above.

Good news is I've been clean since March 21st of this year and have re-dedicated myself to getting healthy and back in shape! I've got a great NMD I see who helped me get off all the meds and reduced my withdrawal time considerably through the use of IV nutritional therapy. He's been a god send for sure.... With his help and some serious lifestyle changes I was able to get back into the gym and start training again by the middle/end of April and have been at it ever since!

Now I'm no stranger to hard work on the job or in the gym. However, after getting over withdrawls and such from the meds I noticed I didn't "feel" at all like I did before. I had all the classic symptoms of low T that I would later find can be caused from the narcotics I was on. I had a hard time finding a doc who would treat me but after a few attempts with other docs finally got my NMD to treat me.


Here are my starting labs from an anti-aging MD drawn on 6/24/10:
Total test = 295 ---Range--- 250-1100 ng/dL
Free test = 81.2 ---Range---- 224 pg/mL
Bio-avail test = 181 ---Range---- 575 ng/dL
SHGB = 9 ---Range---- 9-45 nmol/L
T3 reverse = 11 ---Range---- 11-32 ng/dL
T3 free non-d = 3.3 ---Range---- 2.0-4.8 pg/mL
T4 free non-d = 1.2 ---Range--- .8-1.7 ng/dL

And these are the results 6 weeks after beginning 100mg weekly test cyp shots drawn on 10/08/10:
Total test = 240 (L) ---Range---- 250-1100 ng/dL
Free test = 66.3 ---Range--- 35-155 ng/dL
%Free test = 2.76 (H) ---Range--- 1.5-2.2 %
T4 Free non-d = 1.5 ---Range--- .8-1.7 ng/dL
FSH = .2 (L) ---Range--- 1.5-12.4 mIU/mL
LH = <0.01(L) ---Range--- 1.7-8.6 mIU/mL
Estradiol = 36 ---Range--- 8-43
IGF-1 = 380 (H) ---Range--- 50-303

Unfortunately no IGF-1, estradiol, FSH or LH levels were taken prior to beginning treatment for comparison. However, I'm not surprised that my FSH/LH levels are in the dumper considering I'd been injecting test for 6 weeks.

The estradiol is of concern to me and why I think my TT & FT are in the dumper. Not sure why my IGF levels were so high but I'm not complaining. To combat the higher estradiol my doc started me on 1000mg Calclium D-Glucarate bid and 200mg DIM bid. New labs will be drawn 3 weeks out from the last ones to check estradiol and test levels.

Last but not least I wanted to add that I began using GHRP-6/cjc-1295 @100/100 tid as well.

Any direction, advice, input, etc.... is greatly appreciated!

Thanks
 
With low shbg I be concerned with thyroid imbalance or insulin resistance. Lower the shbg the more frequent the injections need to be do to the body will metabolize it very quickly as you soon found out. Twice a week injection or EOD with insulin pins 29 gauge 1/2 inch would be the most logical route. I have seen this in many of our patients. Free T is not valid reading and is only 1% of ciruculating testosterone. Your bio T is what counts and with low SHBG is actually very high. This is usually the cause in insulin resistance and prediabetic states. Given your age TRT is the right approach, but GHRP should not be added in untill all other hormones are in check such as adrenals, thyroid, dhea, estrodial, and testosterone as well as estrogen metabolites down stream which no dr ever checks. I applaud your NMD about getting you rebalanced again because that is fantastic as I always encounter resistance from other people on the boards about giving it a should. Calcium D also detoxifies hormones IE testosterone, and thyroid so you need to be careful. This is a fact that alot of dr's are unaware of again. DIM needs to be metabolized properly with TMG or sam-e to keep the methylation pathway open. DIM may not lower e2 but will keep estrogen 2, 16 OHE in check. You need also to recheck DHEA-s as this can drop in TRT over time. I use 24 hour urine dhea vs serum as it shows how the body is metabolism. I have ran into cases similar to yours in the past. Hope this helps.
 
The Matrix said:
With low shbg I be concerned with thyroid imbalance or insulin resistance. Lower the shbg the more frequent the injections need to be do to the body will metabolize it very quickly as you soon found out. Twice a week injection or EOD with insulin pins 29 gauge 1/2 inch would be the most logical route. I have seen this in many of our patients. Free T is not valid reading and is only 1% of ciruculating testosterone. Your bio T is what counts and with low SHBG is actually very high. This is usually the cause in insulin resistance and prediabetic states. Given your age TRT is the right approach, but GHRP should not be added in untill all other hormones are in check such as adrenals, thyroid, dhea, estrodial, and testosterone as well as estrogen metabolites down stream which no dr ever checks. I applaud your NMD about getting you rebalanced again because that is fantastic as I always encounter resistance from other people on the boards about giving it a should. Calcium D also detoxifies hormones IE testosterone, and thyroid so you need to be careful. This is a fact that alot of dr's are unaware of again. DIM needs to be metabolized properly with TMG or sam-e to keep the methylation pathway open. DIM may not lower e2 but will keep estrogen 2, 16 OHE in check. You need also to recheck DHEA-s as this can drop in TRT over time. I use 24 hour urine dhea vs serum as it shows how the body is metabolism. I have ran into cases similar to yours in the past. Hope this helps.
Click to expand...

Thanks for the response, I appreciate it very much...

As far as DHEA I had it checked before starting TRT but didn't add it in. The level was 254 with the ranges being 95-530. I also was taking 100mg of DHEA but stopped... should I start it up again?

I will be having new labs drawn in another week or two so that being said are there suggestions as to what else I should have my doc order? He's very open to my suggestions and I'm sure he'll be fine with adding it in.

He's really a great guy and very good at everything I've used him for in the past but I'm leery of how up on TRT he is or not. I'm just grateful at this point that he's been kind enough to start me on the TRT.

Also, my glucose levels are usually about a 90 in the morning, this is what my lab level was I just didn't include it. I check my blood sugar levels occasionally with a glucose meter as well and have usually been where I mentioned above. This am I was at 85 and after a carb meal with protein have tested at 125 or so. Is this right about an hour after eating?

I have much more lab info but only included what I thought was pertinent . If you'd like to know more let me know.

Please advise me on your thoughts/suggestions
 
So your testosterone level was lower after 6 weeks of shots than it was when you started? Have you considered going to 200mg? How is your fatigue? How is digestion?
 
bomb402 said:
So your testosterone level was lower after 6 weeks of shots than it was when you started? Have you considered going to 200mg? How is your fatigue? How is digestion?
Click to expand...
As usually in TRT more is not better just optimizing what is there is the most logical solution which can be done by adding in HCG a few times a week to give him a nice boost between shots.
 
bomb402 said:
So your testosterone level was lower after 6 weeks of shots than it was when you started? Have you considered going to 200mg? How is your fatigue? How is digestion?
Click to expand...

Yes, I've considered 200 but want to figure things out first before upping the dose.

I've had more energy than before starting but still not where I'd like to be. As far as digestion, I "think" it's good. I usually eat at least five and some times 6 or 7 times a day if I have the time. I take in about 3000-3300 calories daily all from lean proteins, clean carbs and healthy fats divided equally throughout the day.

The Matrix said:
As usually in TRT more is not better just optimizing what is there is the most logical solution which can be done by adding in HCG a few times a week to give him a nice boost between shots.
Click to expand...

I've been curious about HCG but think that I'd like to try twice weekly injections and see where that puts me. I'm definitely gonna ask my doc about it....
 
Well I'd get labs done day after the shot first thing upon waking in the morning after some breakfast at say 7 AM. That's the only way to do it. You may have burned through all the hormones you never know unless you do it that way.
 
bomb402 said:
Well I'd get labs done day after the shot first thing upon waking in the morning after some breakfast at say 7 AM. That's the only way to do it. You may have burned through all the hormones you never know unless you do it that way.
Click to expand...

I did my last labs 7 days after the last shot, the morning of my shot day before the shot. I'm thinking of doing Tuesday/Friday shots at 50mg each and have a lab drawn on Tuesday am before my shot.

I've read a few places where some guys just have to do twice weekly or some variation thereof to keep estrogen in check and levels up and steady. I'm gonna start with this and see where I wind up.

Still be curious to hear back from Matrix on further labs to be drawn....

Edit: You mentioned testing in the morning "after" breakfast? Does having a meal make an impact on the results? Just curious....
 
8thangel said:
I did my last labs 7 days after the last shot, the morning of my shot day before the shot. I'm thinking of doing Tuesday/Friday shots at 50mg each and have a lab drawn on Tuesday am before my shot.
Click to expand...

There you go Sherlock. That's why your levels show up low...lol
My SHBG is low like yours. I feel good on test as well! Any aesthetic signs of shutdown yet?
 
My doc has me on 100mg test every five days. I had to go through Androgel, Testim and various dosing schedules of Test before we figured it all out. I finally went from about 300 to 775.

Just keep adjusting until you unlock your perfect combo.....
 
bomb402 said:
There you go Sherlock. That's why your levels show up low...lol
My SHBG is low like yours. I feel good on test as well! Any aesthetic signs of shutdown yet?
Click to expand...

I was told this was the way to get tested, am I missing something? You will certainly be at a "lower point" but still... shouldn't be 50 points lower than prior to beginning shots?

Can't tell if the boys are shrinking any yet or not? I thought maybe a little but don't know if I'm just over thinking?

My wife and I are done having any more kids so I'm not worried about losing fertility but I sure don't want anything "shrinking" on me either, lol!~

Presa said:
My doc has me on 100mg test every five days. I had to go through Androgel, Testim and various dosing schedules of Test before we figured it all out. I finally went from about 300 to 775.

Just keep adjusting until you unlock your perfect combo.....
Click to expand...

I just shot 50mg this am and will do another 50 on Thursday or Friday? I'm thinking twice a week but there's no way to keep it even that way. Injections would be every 3rd or 4th day this way. Could go with every E3D but I think whatever I do I need to be consistent.

That said I'm gonna try twice a week and see where my numbers wind up at and adjust from there accordingly.

I will continue to keep this updated and still welcome any comments/advice.

Thanks
 
Lil update....

Got my lab slip and will be getting my blood drawn on Tuesday am... Hope my T numbers come up, if not I'm going to be hitting my doc up for increased dose and or HCG on top of my current protocol.

I'll update when I get my labs back.
 
8thangel said:
Lil update....

Got my lab slip and will be getting my blood drawn on Tuesday am... Hope my T numbers come up, if not I'm going to be hitting my doc up for increased dose and or HCG on top of my current protocol.

I'll update when I get my labs back.
Click to expand...

Adding HCG on top of it should be all that is needed..
 
8thangel said:
What's a good amount/dose to begin with that I can request from my doc? It would be helpful for me to be armed with some info when I ask...

Thanks
Click to expand...

when you get your total testosterone with just the shots at trought to 500-600 then one can add HCG 250 ius day before your shots if you are doing twice weekly. 2 days before your shot if you are doing once weekly,
 
The Matrix said:
when you get your total testosterone with just the shots at trought to 500-600 then one can add HCG 250 ius day before your shots if you are doing twice weekly. 2 days before your shot if you are doing once weekly,
Click to expand...

Thanks Matrix, I appreciate the advice... I just hope I'm actually as high as 500-600. I'm a bit skeptical that I will be that high but I guess we'll see.

I last shot 50mg on Mon am and I'm going for labs tomorrow before my other 50mg's for the week. Hoping for good things but like I say... a little bit skeptical just yet. Hoping my doc's gonna play ball too. Despite being at TT of 240 last time he seemed to think that because my % of free T was "high" that it was a "good thing". I guess maybe it might be but I don't see how having a high percentage of a very low number is a "good thing"????

I'll post the results once I get them, probably first part of next week I'm guessing?
 
Finally got my labs back....

Well, it took long enough but I finally got my lab results and they're not too bad since switching to twice a week shots.

Here's the numbers:

Total Testosterone= 602 [Range 250-1100ng/dL]
Free Testosterone= 197.4 [Range 46-224pg/ml]
Bio-available Test= 414.5 [Range 110-575ng/dL]
SHGB= 8 L* [Range 9-45nmol/L]
Estradiol= 55 H* [Range 8-43pg/ml]
DHEA= 428 [Range 61-1636ng/dL]

I feel pretty happy with the results although I'm slightly concerned at the high estradiol? I'm not sure how I'm even carrying it either since this is a "total" number. Can you let me know how to ask my doc to request the breakdown for my next lab? I was taking Calcium D-Glucarate @1000mg bid and DIM @100mg bid so it would seem to me that those are not adequate. I asked my doc about switching to Armidex at a low dose eod but he was hesitant. He said, "that's normal when you're on test" and he'd prefer going the natural route for AI. He said he'd have to do some studying on it.... Any suggestions for this Matrix natural or otherwise?

I started taking DHEA 100mg daily as well prior to testing for a few weeks and it looks like a good change I guess? My result last time was 254 with the range being 95-530ug/dL. Number "seems higher" this time but I'm unsure of the comparison between ug/dL vs ng/dL? Maybe you could enlighten on this Matrix?

Please let me know what you think on all this when you can. I'd still like to boost up a bit into the upper range for TT so, I'm thinking I could go ahead with the 250iu's HCG before my shots during the week then?

Lmk,

Thanks
 
8thangel said:
Bump? Matrix? Maybe you're out of town?
Click to expand...

With e2 that high it needs to be rectified by examing the potential causes.
When dealing with high e2 I look at several factors. If all these factors are in balance then I recommand asking your doctor for armidex starting at .25 every other day then retest in 4 weeks. If you get morning erections then they go away then you went to low. You stop the adex untill they return then drop the dosage to .25 mgs every 3 day. With shbg of 8 I would look to insulin resistance, hidden thyroid disorder, excess body fat, or low fiber in diet. With shbg that low e2 needs to be 15-20 level and multiple shots of testosteorne or even gels daily application may be better. If you need fine tuning I am availabe for consultations. I need to look at several variables which is going to take alot more time to get to potential root cause.
 
The Matrix said:
With e2 that high it needs to be rectified by examing the potential causes.
When dealing with high e2 I look at several factors. If all these factors are in balance then I recommand asking your doctor for armidex starting at .25 every other day then retest in 4 weeks. If you get morning erections then they go away then you went to low. You stop the adex untill they return then drop the dosage to .25 mgs every 3 day. With shbg of 8 I would look to insulin resistance, hidden thyroid disorder, excess body fat, or low fiber in diet. With shbg that low e2 needs to be 15-20 level and multiple shots of testosteorne or even gels daily application may be better. If you need fine tuning I am availabe for consultations. I need to look at several variables which is going to take alot more time to get to potential root cause.
Click to expand...

Thanks Matrix,

I'll try and add more fiber to my diet to start. I think backing off on carbs may help a bit with any insulin resistance as well? I've been trying to "bulk" during the last few months and have been eating a LOT of complex carbs. I don't eat any after 6pm but think I'm gonna try backing them down some and see what happens. Additionally I'm upping my dim and Calcium D-GLucarate.

As far as thyroid goes my TSH was 0.97 with a range of 0.45-4.5mU/L. Don't know what that means other than being in the low end of the scale but maybe you could expound a bit? The lab test for this was ordered as TSH w/Reflex to free T4. Again, not sure what baring this has but I'm anxious to here whatever else you would have to say.

8th
 
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